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Non-Steroidal Anti-Inflammatory Drug Effects on Core Temperature University of South Carolina Scholar Commons Theses and Dissertations 6-30-2016 Non-Steroidal Anti-Inflammatory Drug Effects On Core Temperature, Hydration, Gastrointestinal Distress, And Performance In Exercising Humans Dawn Marie Emerson University of South Carolina Follow this and additional works at: https://scholarcommons.sc.edu/etd Part of the Other Medicine and Health Sciences Commons Recommended Citation Emerson, D. M.(2016). Non-Steroidal Anti-Inflammatory Drug Effects On Core Temperature, Hydration, Gastrointestinal Distress, And Performance In Exercising Humans. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/3402 This Open Access Dissertation is brought to you by Scholar Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. NON-STEROIDAL ANTI-INFLAMMATORY DRUG EFFECTS ON CORE TEMPERATURE, HYDRATION, GASTROINTESTINAL DISTRESS, AND PERFORMANCE IN EXERCISING HUMANS by Dawn Marie Emerson Bachelor of Science The University of Alabama, 2006 Master of Science University of South Carolina, 2009 Submitted in Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy in Exercise Science The Norman J. Arnold School of Public Health University of South Carolina 2016 Accepted by: J. Mark Davis, Major Professor Toni M. Torres-McGehee, Committee Member J. Larry Durstine, Committee Member Stephen CL Chen, Committee Member Lacy Ford, Senior Vice Provost and Dean of Graduate Studies © Copyright by Dawn Marie Emerson, 2016 All Rights Reserved. ii DEDICATION To the Lord, Our God. I would have nothing without Him. All joy, love, patience, and success in my life and surrounding this project is because of Him who blessed me. He is by my side in my weakness, turmoil, frustration, doubt, and anger. He does not give up, but challenges, encourages, and guides. I offer this and everything I do to Him. Credo in unum Deum, Patrem omnipotentem, factorem caeli et terrae, visibilium omnium et invisibilium, Et in unum Dominum Iesum Christum, Filium Dei unigenitum, et ex Patre natum, ante omnia saecula, Deum de Deo, lumen de Lumine, Deum verum de Deo vero, genitum, non factum, consubstantialem Patri: per quem omnia facta sunt. Qui propter nos homines et propter nostram salutem descendit de caelis. Et incarnatus est de Spiritu Sancto ex Maria Virgine, et homo factus est. Crucifixus etiam pro nobis sub Pontio Pilato; passus et sepultus est, et resurrexit tertia die, secundem Scripturas, et ascendit in caelum, sedet ad dexteram Patris. Et iterum venturus est cum gloria, iudicare vivos et mortuos, cuius regni non erit finis. Et in Spiritum Sanctum, Dominum et vivificantem: qui ex Patre Filioque procedit. Qui cum Patre et Filio simul adoratur et conglorificatur: qui locutus est per prophetas. Et nuam, sanctam, catholicam et apostolicam Ecclesiam. Confiteor unum baptisma in remissionem peccatorum. Et exspecto resurrectionem mortuorum, et vitam venturi saeculi. Amen. iii ACKNOWLEDGEMENTS Deepest appreciation to Dr. Mark Davis for mentoring me throughout my entire time at USC. I would have never had this opportunity without his patience and willingness to educate. Thank you is hardly enough for Dr. Toni Torres-McGehee’s motivation, encouragement, mentorship, and friendship. Special thanks to Dr. Stephen Chen for his willingness to help in numerous capacities. Thank you to Dr. Larry Durstine for his time, expertise, humor, and easy going attitude. Immense gratitude to Dr. Brian Keisler for being “on-call” and assisting through several challenges. Thank you to all the research assistants, especially Joe Bivona and Justin Stone for their commitment, brilliant minds, wit, and fortitude. Tremendous thanks to Craig Pfeifer; I could not have finished this without him. Thank you participants. Thank you Riley Enos for spending hours pipetting and making concoctions. Much gratitude to Dr. Angela Murphy and Kei Lam at the School of Medicine, Drs. William Cotham and Michael Walla and their team in the Department of Biochemistry, and Jackson Murphy at Hawthorne Pharmacy. I thank the National Athletic Trainers’ Association Foundation and the American College of Sports Medicine for funding portions of this study. I share my excitement with my parents, grandmothers, extended family, in-laws, and numerous friends (wish I could name you all). All of them had faith I could complete this endeavor, even if they did not understand what I was doing. I cannot thank my husband, Charlie, enough. You have been my soundboard, helped in any way I asked, reassured me when I felt like giving up, celebrated all the high points, and challenged me to be stronger. I could not have accomplished this without you! iv ABSTRACT Naproxen is a commonly used non-steroidal anti-inflammatory drug designed to relieve pain and inflammation. Due to potentially adverse effects on the gastrointestinal (GI) tract, cardiovascular and immune system, and renal function, naproxen may negatively affect thermoregulation, fluid and electrolyte balance, and performance during exercise, particularly in the heat. Therefore, the purpose of this study was to determine the effects of naproxen on core temperature (Tc), inflammation, hydration, GI distress, and performance during cycling in a hot environment. We utilized a double-blind, randomized and counterbalanced, cross-over design to determine the effects of naproxen (dose = 3 220 mg naproxen sodium pills) or placebo (3 cellulose pills) on the dependent variables: Tc, interleukin-6 (IL-6), GI distress symptoms, fecal occult blood, plasma sodium and potassium concentration, plasma osmolality, urine osmolality, urine specific gravity, percent change in body mass, urine volume, fluid volume, heart rate, blood pressure, rate of perceived exertion, and distance during a 10 min time trial. Participants (n = 11, age = 27.8 + 5.7 yrs, weight = 79.1 + 17.9 kg, and V̇ O2max = 41.4 + 5.7 mL/kg) completed 4 conditions: 1) placebo and ambient (Control); 2) naproxen and ambient (Npx); 3) placebo and heat (Heat); and 4) naproxen and heat (NpxHeat) separated by a minimum of 7 days. Dependent measures were taken pre-, during, post-, and 3 hrs post- a 90 min cycling protocol. We found no statistically significant differences between experimental conditions for any dependent variable. Exercise induced significant overall increases pre- to post- for Tc, IL-6, plasma potassium, heart rate, blood pressure, perceived exertion, and GI distress. v Compared to placebo, naproxen generally led to higher fluid intake and lower urine volume. Mean distance traveled was highest during Npx (3.3 + 0.8 miles) and lowest in NpxHeat (2.8 + 0.8 miles). Participants experienced greater GI distress during Heat, especially day post-exercise. During exercise, GI symptom occurred in 64% of trials. Interestingly, dizziness and headache were only reported during placebo conditions, with generally less systemic symptoms during exercise with naproxen use. In conclusion, our results do not support our hypotheses that naproxen would increase Tc, IL-6, and GI distress, alter fluid-electrolyte balance, and decrease performance compared to placebos. vi TABLE OF CONTENTS DEDICATION ....................................................................................................................... iii ACKNOWLEDGEMENTS ........................................................................................................ iv ABSTRACT ............................................................................................................................v LIST OF TABLES ....................................................................................................................x LIST OF FIGURES ................................................................................................................. xi LIST OF SYMBOLS .............................................................................................................. xii LIST OF ABBREVIATIONS ................................................................................................... xiii CHAPTER 1 OVERALL INTRODUCTION ...................................................................................1 CHAPTER 2 NAPROXEN EFFECTS ON CORE TEMPERATURE AND INFLAMMATION DURING CYCLING IN THE HEAT ..........................................................8 ABSTRACT ...................................................................................................................9 INTRODUCTION ..........................................................................................................10 METHODS ..................................................................................................................11 RESULTS ....................................................................................................................17 DISCUSSION ...............................................................................................................19 REFERENCES .............................................................................................................25 CHAPTER 3 NAPROXEN EFFECTS ON HYDRATION AND ELECTROLYTE MEASURES DURING CYCLING IN THE HEAT ...............................................................36 vii ABSTRACT .................................................................................................................37 INTRODUCTION ..........................................................................................................38
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